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2026-2027 Vaccine Guidance for Leukemia: 6 Facts About Protection Against COVID, Flu, and RSV

Written by Ted Samson
Posted on October 5, 2026

Key Takeaways

  • Updated vaccine recommendations for flu, COVID-19, and RSV have been released for the 2026-27 respiratory season, and they carry special importance for people living with leukemia.
  • Leukemia and its treatments can weaken the immune system, making respiratory infections more serious, so knowing which vaccines are available and approved is an important step. For the upcoming season, there are updated COVID-19 and flu vaccine options, as well as three RSV vaccines for adults, each approved for different age groups and risk levels.
  • Because the right vaccine type, dose, and timing can vary greatly depending on your treatment plan and immune function, talking with your oncology team is the best way to figure out which vaccines make sense for you and when to get them.
  • View all takeaways

Several leading medical organizations have released updated recommendations for flu, COVID-19, and respiratory syncytial virus (RSV) vaccines for the 2026-27 respiratory season. The guidance, available through the Vaccine Integrity Project, is especially important for people with leukemia.

Leukemia and some of its treatments can weaken immune defenses and increase the risk of serious infection from respiratory viruses.

Vaccines train the immune system to recognize and fight specific viruses. This can help your body respond more quickly if you’re exposed to them.

🗳️ Have you spoken with your doctor about COVID-19, flu, or RSV vaccinations for 2026-2027?
Yes, and it was helpful.
Yes, but it wasn’t helpful.
No, but I plan to.
No, and I don’t plan to.

There isn’t one vaccine plan that’s right for everyone with leukemia. Your age, treatment plan, immune function, vaccination history, and other health conditions can all influence which vaccines are recommended and when you should receive them.

1

The New Vaccine Guidance Comes From Leading Medical Groups

The Vaccine Integrity Project, working with the American Medical Association, reviewed the latest evidence on flu, COVID-19, and RSV immunizations for the 2026-27 respiratory season. The findings helped inform recommendations from several leading medical organizations, including:

  • American Academy of Family Physicians
  • American Academy of Pediatrics
  • American College of Obstetricians and Gynecologists
  • Infectious Diseases Society of America (IDSA)

The review included 299 studies published mostly between August 2025 and June 2026. It found that flu, COVID-19, and RSV immunizations continued to provide meaningful protection against hospitalization, severe illness, and death.

Flu, COVID-19, and RSV immunizations continue to provide meaningful protection against hospitalization, severe illness, and death.

The amount of protection can vary based on the virus, the vaccine or immunization, the season, and a person’s health. For people with leukemia, vaccination decisions may also depend on age, the type and timing of treatment, and how well the immune system is working.

2

There Are Several New and Updated Vaccine Options

For the 2026-27 respiratory season, COVID-19 and flu vaccines have updated formulations. There are also three RSV vaccines for adults. These vaccines differ in how they are made and which age groups or risk groups they are approved for.

COVID-19 Vaccines

The U.S. Food and Drug Administration (FDA) has approved four COVID-19 vaccine options. All four vaccines are given by injection.

Vaccine Vaccine Type FDA-Approved Age Groups
Moderna mNexspike mRNA People 65 and older; people ages 12 through 64 with at least one underlying condition that increases their risk of severe COVID-19
Moderna Spikevax mRNA People 65 and older; people ages 6 months through 64 with at least one underlying condition that increases their risk of severe COVID-19
Novavax Nuvaxovid Protein-based with an adjuvant (an ingredient that helps strengthen the immune response) People 65 and older; people ages 12 through 64 with at least one underlying condition that increases their risk of severe COVID-19
Pfizer Comirnaty mRNA People 65 and older; people ages 5 through 64 with at least one underlying condition that increases their risk of severe COVID-19

The IDSA recommends that people with weakened immune systems discuss receiving a second dose of the COVID-19 vaccine two to six months after the first dose.

Flu Vaccines

All U.S. flu vaccines for the 2026-27 season are trivalent, meaning they are designed to protect against three influenza viruses.

Afluria, Fluarix, FluLaval, and Fluzone
Vaccine Type
Standard-dose, egg-based, inactivated
How It’s Given
Injection
FDA-Approved Age Groups
People 6 months and older
Fluad
Vaccine Type
Egg-based, inactivated, contains an adjuvant
How It’s Given
Injection
FDA-Approved Age Groups
People 65 and older
Flublok
Vaccine Type
Recombinant, made without eggs
How It’s Given
Injection
FDA-Approved Age Groups
People 9 and older
FluMist
Vaccine Type
Egg-based, live attenuated
How It’s Given
Nasal spray
FDA-Approved Age Groups
People ages 2 through 49
Fluzone High-Dose
Vaccine Type
Egg-based, inactivated, higher antigen dose
How It’s Given
Injection
FDA-Approved Age Groups
People 65 and older
Moderna mFlusiva
Vaccine Type
mRNA
How It’s Given
Injection
FDA-Approved Age Groups
People 50 and older

Most people need one flu vaccine dose each season. Some children may need a second dose based on their age, vaccination history, or individual health circumstances. For people with leukemia the timing of the flu vaccine may need to be coordinated with treatment.

People who are immunocompromised shouldn’t receive the live-attenuated nasal flu vaccine FluMist, per guidance from the U.S. Centers for Disease Control and Prevention (CDC) and IDSA.

RSV Vaccines

There are three FDA-approved adult RSV vaccines.

Vaccine Vaccine Type FDA-Approved Adult Use
GSK Arexvy Protein-based vaccine with an adjuvant People 60 and older; people ages 18 through 59 at increased risk of RSV lower respiratory tract disease
Moderna mResvia mRNA vaccine People 60 and older; people ages 18 through 59 at increased risk of RSV lower respiratory tract disease
Pfizer Abrysvo Protein-based vaccine without an adjuvant People 60 and older; people ages 18 through 59 at increased risk of RSV lower respiratory tract disease; pregnant people at 32 through 36 weeks of pregnancy to help protect their infants from RSV

For adults, the CDC recommends a single dose of RSV vaccine for everyone age 75 and older and for adults ages 50 through 74 who are at increased risk of severe RSV illness. For people with weakened immune systems, including those with leukemia, the IDSA recommends RSV vaccination starting at age 18. The RSV vaccine isn’t currently given every year.

3

Vaccine Benefits Typically Outweigh Risks

For people who are immunocompromised, the benefits of vaccination generally outweigh the risks. Current evidence shows that flu, COVID-19, and RSV immunizations can reduce hospitalization, severe illness, and death. People with weakened immune systems may not respond as strongly to vaccines, but vaccination can still provide protection.

Vaccines can cause side effects, but serious side effects are uncommon. Your healthcare team can explain what to expect and help you weigh the benefits and risks based on your:

  • Treatment plan
  • Immune function
  • Age
  • Previous reactions
  • Other health conditions
4

There Are Special Considerations for People With Leukemia

The right vaccine and timing can vary for people with leukemia. Leukemia and its treatments can affect immune function, so your vaccine response and the best time to get vaccinated may vary.

It’s important to ask not only which products are available, but which type, dose, and timing make sense for you.

Your healthcare team may consider:

  • Which leukemia treatments you’re receiving and how they affect immune function
  • How much your immune system is suppressed and whether your response to vaccination may be reduced
  • Whether you’ve had a stem cell transplant or chimeric antigen receptor (CAR) T-cell therapy, which can affect when you should be vaccinated or revaccinated
  • Your age, other health conditions, and previous vaccination history
  • Which vaccines and doses you’ve already received, including whether an additional COVID-19 dose may be appropriate

Some vaccine types may not be appropriate for people with leukemia. For example, the nasal spray flu vaccine is a live vaccine and should not be used in people with weakened immune systems.

Timing Around Treatments

Timing may also matter. The American Society of Clinical Oncology recommends getting vaccinated two to four weeks before planned cancer treatment when possible. However, nonlive vaccines can also be given during or after chemotherapy, immunotherapy, radiation, or surgery.

For people with blood cancers such as leukemia, the IDSA recommends coordinating vaccination with treatment cycles when possible. People who have had a stem cell transplant or CAR T-cell therapy may need a different vaccination schedule.

Your oncology team can recommend the best timing based on your treatment and immune function. Don’t delay, skip, or change leukemia treatment to get vaccinated unless your oncology team recommends it.

5

A Weaker Vaccine Response Can Still Offer Protection

People with weakened immune systems may not develop as strong a response to vaccines as people with healthy immune systems. That doesn’t mean vaccination has no benefit.

People with weakened immune systems may not develop as strong a response to vaccines as people with healthy immune systems. That doesn’t mean vaccination has no benefit.

The Vaccine Integrity Project found that respiratory-virus immunizations continued to reduce severe outcomes among people with immunocompromising conditions, although protection varied.

6

For Some People, Several Vaccines May Be Given at Once

In many cases, COVID-19, flu, and RSV vaccines can be given at the same visit.

Whether that makes sense for you may depend on your treatment schedule, previous vaccinations, expected side effects, and other health needs. Ask your oncology team whether getting more than one vaccine at the same appointment is appropriate.

7

Questions To Ask Your Oncology Team About Seasonal Vaccines

  1. Which flu, COVID-19, and RSV vaccines do you recommend for me?
  2. Does my current leukemia treatment affect which vaccines I should receive?
  3. Is there a best time to get vaccinated within my treatment schedule?
  4. Do I need an additional COVID-19 vaccine dose?
  5. Should I receive an RSV vaccine this season?
  6. Can I receive more than one vaccine at the same appointment?
  7. Does a previous stem cell transplant or CAR T-cell therapy change my vaccine schedule?
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